PITFALLS OF MEDICATING APATHY [ back to What's New ]
A common sequelae of frontal lobe injury is apathy or loss of ability to spontaneously initiate activity. Persons with this executive function disorder symptom cannot set themselves in motion, and need constant reminders from others to do just about anything, even eat a meal.  In the January 1999 edition of Brain Injury, it was reported that administration of the drug Amantadine, which stimulates extra release and utilization of dopamine, helped a female patient with bilateral front lobe injury overcome her apathy. However, the higher dosage required to achieve this led to the opposite problem of agitation, impulsivity and aggression. Lowering the dose stopped the side effects, but she became apathetic again. Fine tuning the dosage to obtain the benefit while avoiding undesirable side effects is no easy matter, as this report shows. The authors recommend further trials of amantadine and other dopamine agonists such as bromocriptine and sinemet in hopes of finding the right balance of meds.